STUDENT OFFICER ELIGIBILITY APPEAL FORM | Revised 10/29/2019

Student Officer Eligibility Appeal Form

Section 1: Name______________________________________________UF-ID___________________________

Telephone No. ______________________________ UF E-Mail_________________________________

College_________________________ Major_______________ Classification_________

Current Course Load___________________ UF Cumulative GPA__________________ Name of organization(s) affiliated with and elected/appointed office(s) held: __________________________________________________________________________________________________ __________________________________________________________________________________________________ Section 2: Please check the appropriate reason for ineligibility. Then complete Section 3 and each additional Section next to the reason(s) selected:

□ GPA (Complete Section 4) □ Course Load Credit Hour Enrollment (Undergraduate) (Complete Section 4)

□ Course Load Credit Hour Enrollment (Graduate) (Complete Section 4)

□ Conduct (Complete Section 5) □ Financial (Complete Section 6)

Section 3: Based on the ineligibility reason provided, please provide a brief explanation for the basis of your appeal (attach additional pages if necessary). __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Appellant Signature____________________________________ Date_____________ Based on your ineligibility reason above, please obtain a supporting statement and signature from the appropriate authorized staff member in conjunction with your ineligibility (See Below). You may submit one appeal form for multiple ineligibility reasons but you will need to obtain all appropriate signatures and supporting statements that coincide with your selection above.

STUDENT OFFICER ELIGIBILITY APPEAL FORM | Revised 10/29/2019

Section 4: If you checked GPA and/or Course Load/Credit Hour Enrollment for either Undergraduate/Graduate please obtain a supporting statement and signature from your Academic Advisor. (Attach additional pages if necessary). __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________

Academic Advisor Signature: _________________________________________ Date: __________________

Title: _________________________________ Phone Number: _________________________________ Section 5: If you checked Conduct please obtain a supporting statement and signature from the appropriate staff member in the Dean of Students, Office of Student Conduct and Conflict Resolution (Attach additional pages if necessary): __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________

SCCR Signature: ____________________________________________ Date: __________________

Title: _________________________________ Phone Number: _________________________________

Section 6: If you checked Financial please obtain a supporting statement and signature from the appropriate staff member in the UF University Bursar office at the time of resolving your obligations (Attach additional pages if necessary): __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ UF Bursar Authorized Signature: _________________________________________ Date: __________________

Title: _________________________________ Phone Number: _________________________________

Please return you completed appeal form to the Department of Student Activities and Involvement located in the J. Wayne Reitz Union, Level 3, Suite 3100. You will be notified of the committee’s decision by email within (3) three business days of the Student Activities Appeal Committee Meeting. Questions in regards to this form may be directed to email saiorganizations@ufsa.ufl.edu or telephone 352-392-1671.